Document Detail

Wear and lysis is the problem in modular TKA in the young OA patient at 10 years.
MedLine Citation:
PMID:  20568028     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Most long-term followup studies of younger patients who underwent TKA include a relatively high percentage of rheumatoid patients, whose function and implant durability may differ from those with osteoarthritis (OA).
QUESTIONS/PURPOSES: The purpose of this study was to evaluate the minimum 10 year followup of TKA performed in more active patients with OA, using modular tibial components, to determine the durability of that construct. Specifically, we determined (1) survivorship; (2) revision rates; (3) functional scores; and (4) rates of radiographic failure at a minimum 10 year followup.
METHODS: We retrospectively reviewed 59 patients (67 knees) with OA who underwent primary total knee arthroplasty with posterior cruciate retaining (27%) or posterior cruciate substituting (73%) components which had modular tibial trays. Patients were evaluated clinically for need of revision and Knee Society, SF-36 and WOMAC scores as well as UCLA and Tegner activity scores. Radiographs were evaluated for loosening and osteolysis. The minimum followup of living patients was 10 years (mean, 12.4 years; range, 10 to 18.4 years). Ten patients (11 knees) died; two patients (2 knees) were lost to followup.
RESULTS: Ten patients (11 knees; 16%) had revisions for aseptic loosening and/or osteolysis. Thirty-one patients (65%) were still performing moderate labor or sports activities. The average UCLA score was 5.5 (range, 2-9). No nonrevised knee demonstrated radiographic loosening.
CONCLUSION: Most patients in this active patient population continued to have acceptable function although 16% underwent revision for wear and/or osteolysis. Isolated tibial insert exchange alone was performed in four of the 11 (36%) revised knees. These data should provide comparison for total knee arthroplasties performed in younger patients with newer designs and newer bearing materials.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Andrew N Odland; John J Callaghan; Steve S Liu; Christopher W Wells
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-01-25     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  41-7     Citation Subset:  AIM; IM    
University of Iowa, 200 Hawkins Dr, UIHC, 01029 JPP, Iowa City, IA 52242, USA.
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MeSH Terms
Age Factors
Arthroplasty, Replacement, Knee / adverse effects,  instrumentation*
Kaplan-Meier Estimate
Knee Prosthesis*
Middle Aged
Osteoarthritis, Knee / radiography,  surgery*
Osteolysis / etiology,  surgery
Prosthesis Design
Prosthesis Failure
Retrospective Studies
Stress, Mechanical
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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